Gathering data on sexual orientation and gender identity in clinical settings via EHR systems helps clinicians, researchers, and policymakers better understand LGBT health, including disparities in insurance coverage, access to care, diagnosis, and treatment. Storing SOGI information in the EHR promotes seamless communication among staff within health care organizations. Further, these data, coupled with race/ethnicity data, would also allow for better understandings of racial and ethnic disparities within LGBT populations. METHODS
The specific aim of the study was to survey community health center patients to assess the acceptability, feasibility, and patient preferences on asking sexual orientation and gender identity questions to complete their electronic health record intake. The study addressed the following questions: 1. What are the acceptable ways to ask patients about sexual orientation and gender identity in electronic health records? 2. How do patient survey responses differ based on sexual orientation, gender identity, clinical site location, and other demographic variables? Participants. The findings from this study are based on survey responses from 251 patients at four CHARN-affiliated CHCs. By targeting CHCs with diverse patient populations, the goal was to enroll transgender (regardless of sexual orientation), LGB, and heterosexual patients to gather information on appropriate ways to ask sexual orientation and gender identity questions. The inclusion criteria included patients at each participating CHC who were 18 year of
age or older. While the participating CHCs do provide health care to patients younger than 18, this study targeted patients who completed their own registration forms and not patients whose parents or guardians fill out the forms. The exclusion criteria included non-Englishspeaking patients and those who refused to participate. Human subjects protection. The Fenway Institute functioned as the lead site for this study. Beaufort and Chase Brexton, both Fenway-affiliated CHARN sites, use the Fenway Institutional Review Board (IRB) for CHARN-related study projects. All study documents were submitted and approved by the Fenway IRB. The Howard Brown Health Center IRB approved the study for that site. The IRB approved a waiver of documented informed consent due to the anonymous nature of the study and the absence of any personal identifiers attached to the survey. However, participants were provided with a “research information form� for participation in this study (included with informed consent waiver). This form was handed out with the paper survey and included all the essential elements of an informed consent. Continuing on to answer the survey questions indicated that participants voluntarily agreed to participate. Instrument. This one-time, 5-minute survey asked respondents to answer a question about sexual orientation developed at the Fenway Institute, and to answer a two-step gender identity and birth sex question that has been endorsed by leading transgender researchers
ASKING PATIENTS QUESTIONS ABOUT SEXUAL ORIENTATION AND GENDER IDENTITY IN CLINICAL SETTINGS
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